【摘要】 目的  探討肝炎后肝硬化自發(fā)性細(xì)菌性腹膜炎（spontaneous bacterial peritonitis，SBP）的診療情況及頭孢哌酮舒巴坦聯(lián)合左旋氧氟沙星對(duì)SBP的治療效果。 方法  對(duì)2004年1月-2009年12月收治的54例肝炎后肝硬化SBP患者，應(yīng)用頭孢哌酮舒巴坦聯(lián)合左旋氧氟沙星給與治療，并觀察分析治療效果。 結(jié)果  肝炎后肝硬化SBP的臨床表現(xiàn)以發(fā)熱，腹痛為主，具有典型腹膜刺激征的不足半數(shù)。外周血白細(xì)胞升高者不多見，腹腔積液中白細(xì)胞計(jì)數(shù)、PMN計(jì)數(shù)和細(xì)菌培養(yǎng)是自發(fā)性細(xì)菌性腹膜炎的重要診斷指標(biāo)。 結(jié)論  肝炎后肝硬化合并SBP的臨床表現(xiàn)不典型。致病菌以G-桿菌為主。在早期診斷、綜合治療的基礎(chǔ)上，頭孢哌酮舒巴坦聯(lián)合左旋氧氟沙星對(duì)自發(fā)性細(xì)菌性腹膜炎的治療效果顯著。
【Abstract】 Objective  To evaluate the diagnosis and treatment of post-hepatitis cirrhosis complicated with spontaneous bacterial peritonitis (SBP) cases and the efficacy of cefoperazone and sulbactam combined with levofloxacin in the treatment of cirrhotic patients with SBP. Methods  From January 2004 to December 2009, the clinical data from 54 cases of SBP after cirrhosis were analyzed. The patients underwent the treatment of cefoperazone sulbactam combined with levofloxacin. The therapeutic effect was observed. Results  The main clinical manifestations were fever and abdominal pain, and about half of the patients had the typical peritoneal irritation. Only a few patients had elevated peripheral white blood cells (WBC). The WBC count, abdominal effusion polymorphonuclearcyte count and bacteria cultivation were the indexes of diagnosis of SBP. Conclusion  The clinical features of post-hepatitis cirrhosis complicated with SBP are not typical. The main pathogenic bacteria is G- bacilli. In the early diagnosis and treatment, cefoperazone sulbactam combined with levofloxacin is effective.

引用本文： 張策,劉文生. 肝炎后肝硬化自發(fā)性細(xì)菌性腹膜炎臨床分析. 華西醫(yī)學(xué), 2010, 25(9): 1597-1599. doi: 復(fù)制